scholarly journals The Readiness of Psychiatrists to Implement Psychedelic-Assisted Psychotherapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Lisa A. Page ◽  
Ahmad Rehman ◽  
Habib Syed ◽  
Kathryn Forcer ◽  
Graham Campbell
Keyword(s):  
Focus Groups ◽  
Thematic Analysis ◽  
Training Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Methods Approach ◽  
Potential Barriers ◽  
Descriptive Approach ◽  
Attitudes And Knowledge ◽  
Health Trust

Introduction: Psychedelic-assisted psychotherapy is a promising approach in psychiatry; evidence is growing and it may not be long before mainstream services are expected to offer it to selected patients. This pilot study examined the attitudes and knowledge of NHS psychiatrists of all levels towards psychedelic-assisted psychotherapy and explored potential barriers and facilitators to its implementation.Methods: A mixed-methods approach was adopted, using a cross-sectional survey and focus groups. All psychiatrists in one NHS mental health trust were approached by email to participate. The survey was analysed using a simple descriptive approach and thematic analysis was used for the focus groups.Results: Eighty-three (25.7%) psychiatrists participated in the survey. All psychiatrists were familiar with one or more psychedelic substances. Although 77.2% felt that there should be a role for controlled or therapeutic use of psychedelics, trainees appeared better informed than non-training grade psychiatrists. Psychiatrists of all grades did not feel prepared to participate in the delivery of psychedelic-assisted psychotherapy. Thematic analysis of the focus groups identified three main themes in relation to psychedelic-assisted psychotherapy: “need for knowledge,” “openness to change,” and “uncertainty.”Discussion: NHS psychiatrists are positive about the potential for psychedelic-assisted therapy to advance psychiatric practise. However, psychiatrists are lacking in confidence or preparedness to implement this treatment should it become a mainstream option and significant training needs were identified. Thematic analysis highlighted the need for societal shifts as well as professional ones.

scholarly journals Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding

10.2196/19008 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e19008 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Gabriella Landy ◽  
Michelle Eskinazi ◽  
Andrew Sommerlad ◽  
Nicola Morant ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Internet Use ◽  
Child And Adolescent ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Data Set ◽  
Related Risk

Background The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. Objective This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. Methods We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. Results The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;P=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; P=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; P=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; P=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. Conclusions Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

scholarly journals Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding (Preprint)

2020 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Gabriella Landy ◽  
Michelle Eskinazi ◽  
Andrew Sommerlad ◽  
Nicola Morant ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Internet Use ◽  
Child And Adolescent ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Data Set ◽  
Related Risk

BACKGROUND The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. OBJECTIVE This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. METHODS We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. RESULTS The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;<i>P</i>=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; <i>P</i>=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; <i>P</i>=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; <i>P</i>=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. CONCLUSIONS Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

scholarly journals Translation and validation of Training Needs Analysis Questionnaire among reproductive, maternal and newborn health workers in Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tumbwene Mwansisya ◽  
Columba Mbekenga ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
Eunice Pallangyo ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Professional Training ◽  
Health Workers ◽  
Newborn Health ◽  
Training Needs ◽  
Assessment Tools ◽  
Needs Analysis ◽  
Maternal And Newborn Health ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Continuous professional development (CPD) has been reported to enhance healthcare workers’ knowledge and skills, improve retention and recruitment, improve the quality of patient care, and reduce patient mortality. Therefore, validated training needs assessment tools are important to facilitate the design of effective CPD programs. Methods A cross-sectional survey was conducted using self-administered questionnaires. Participants were healthcare workers in reproductive, maternal, and neonatal health (RMNH) from seven hospitals, 12 health centers, and 17 dispensaries in eight districts of Mwanza Region, Tanzania. The training needs analysis (TNA) tool that was used for data collection was adapted and translated into Kiswahili from English version of the Hennessy-Hicks’ Training Need Analysis Questionnaire (TNAQ). Results In total, 153 healthcare workers participated in this study. Most participants were female 83 % (n = 127), and 76 % (n = 115) were nurses. The average age was 39 years, and the mean duration working in RMNH was 7.9 years. The reliability of the adapted TNAQ was 0.954. Assessment of construct validity indicated that the comparative fit index was equal to 1. Conclusions The adapted TNAQ appears to be reliable and valid for identifying professional training needs among healthcare workers in RMNH settings in Mwanza Region, Tanzania. Further studies with larger sample sizes are needed to test the use of the TNAQ in broader healthcare systems and settings.

scholarly journals Attitudes and potential barriers towards hepatitis C treatment in patients with and without HIV coinfection

2017 ◽  
Vol 29 (4) ◽  
pp. 334-340 ◽  
Author(s):  
PR Allyn ◽  
SM O’Malley ◽  
J Ferguson ◽  
CH Tseng ◽  
KW Chew ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Los Angeles ◽  
Treatment Preferences ◽  
Study Cohort ◽  
Hcv Treatment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hepatitis C Treatment ◽  
Potential Barriers ◽  
Hiv Coinfection

This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.

scholarly journals Why Do Women Not Use the Bathroom? Women’s Attitudes and Beliefs on Using Public Restrooms

2020 ◽  
Vol 17 (6) ◽  
pp. 2053
Author(s):  
Siobhan M. Hartigan ◽  
Kemberlee Bonnet ◽  
Leah Chisholm ◽  
Casey Kowalik ◽  
Roger R. Dmochowski ◽  
...  
Keyword(s):  
Conceptual Framework ◽  
Secondary Analysis ◽  
Future Research ◽  
Attitudes And Beliefs ◽  
Behavioral Strategies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Situational Influences ◽  
Mixed Methods Approach ◽  
Data Coding

There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a women’s attitude towards using restrooms at work, at school, and in public in order to develop a conceptual model incorporating these themes. We performed a secondary analysis of a cross-sectional, survey-based study that included open-ended questions about limitations to restroom use using a mixed-methods approach. Qualitative data coding and analysis was performed on 12,583 quotes and, using an iterative inductive-deductive approach, was used to construct the conceptual framework. Our conceptual framework reveals a complicated interplay of personal contexts, situational influences, and behavioral strategies used by women to manage their bladder and bowel habits away from home. These findings can inform future research and public policy related to bladder health awareness related to toilet access in the workplace and in public.

scholarly journals Physiotherapists perceived role in managing anxiety in patients with Relapsing-Remitting Multiple Sclerosis: a mixed-methods study.

2021 ◽  
Author(s):  
Lauren Lucas ◽  
Jack Parker
Keyword(s):  
Mixed Methods ◽  
Clinical Supervision ◽  
Management Practices ◽  
Training Needs ◽  
Outpatient Rehabilitation ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physiotherapy Practice ◽  
The Impact

ABSTRACT Objectives: To explore how physiotherapists manage anxiety in patients with RRMS in community and outpatient settings. To identify further training and research to better develop physiotherapy practice. Design: A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists. Participants: Sixteen UK-registered physiotherapists: 11 in the survey, 5 in the interviews. Methods: To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety, physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results: The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion: Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

Thematic Analysis of Nurses’ Experiences With The Joint Commission’s Medication Management Titration Standards

2021 ◽  
Vol 30 (5) ◽  
pp. 375-384 ◽  
Author(s):  
Judy E. Davidson ◽  
Laura Chechel ◽  
Jose Chavez ◽  
Carol Olff ◽  
Teresa Rincon
Keyword(s):  
Patient Safety ◽  
Thematic Analysis ◽  
Registered Nurse ◽  
Moral Dilemma ◽  
Moral Dilemmas ◽  
Workplace Wellness ◽  
Cross Sectional Survey ◽  
Levels Of Abstraction ◽  
Cross Sectional ◽  
Individualized Care

Background For decades, medication titration has been within nurses’ scope and practice. In 2017 The Joint Commission (TJC) revised elements for orders for the titration of continuous intravenous medications. Objectives To explore the practice and perceptions of nurses regarding TJC standards for titration of continuous intravenous medications. Methods Nurses with experience titrating medications completed an investigator-designed, validated cross-sectional survey. Inductive thematic analysis was conducted in order to analyze the open-ended comments from that quantitative survey. Results From among 730 completed surveys, 159 comments were received. Analysis of the comments yielded 3 levels of abstraction. Two overarching themes were harm and professionalism. Additional abstraction for the harm theme revealed categories of erosion of workplace wellness, moral dilemma, and patient safety, which were coded as relating to workplace stress, workload, burnout/turnover, physical risk, inefficiency, demeaning/devalued, falsification of records, problematic orders, burden of documentation, suboptimal care, delay in care, individualized care, and provider availability. Within the professionalism theme, categories of autonomy and nurse proficiency were identified, with 7 associated codes: top of scope, critical thinking, overregulation, teamwork, education, registered nurse knowledge, and novice registered nurse guidance. Conclusions The standards from TJC impose harm by eroding workplace wellness and introducing moral dilemmas and patient safety concerns. Professionalism is threatened through limits on scope and autonomy. Further advocacy is necessary in order to resolve unanticipated consequences related to the titration standards.

Perceptions and Attitudes of Pharmacogenomics Through the Lens of Community Pharmacists and Patients

2021 ◽  
pp. 21-30
Author(s):  
Dalga Surofchy ◽  
Christina Mnatzaganian ◽  
Lord Sarino ◽  
Grace Kuo
Keyword(s):  
Healthcare Workers ◽  
Community Pharmacists ◽  
Survey Study ◽  
Routine Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potential Barriers ◽  
Perceptions And Attitudes ◽  
Practice Methods ◽  
Pharmacy Chain

Background Pharmacists represent some of the most accessible healthcare workers and are in an opportune position to spearhead new clinical initiatives, such as pharmacogenomics (PGx) services. It is important that we understand the perceptions and attitudes both pharmacists and patients have regarding PGx and potential barriers of implementing it into routine clinical practice. Methods A cross-sectional survey study was conducted across one regional division of a large community pharmacy chain to assess the perceptions and attitudes of pharmacists and patients regarding PGx in California. A secondary aim was to determine perceived barriers to PGx implementation into community pharmacies. Results The majority (67%) of pharmacists agreed or strongly agreed to understanding PGx compared to 35% of patients being aware of PGx (p<0.001). More patients (62%) preferred their pharmacist compared to pharmacists (43%) preferring themselves as a provider to manage patients' medications based on their PGx results (p<0.01). Many patients (88%) expressed interest in participating in a PGx test; both pharmacists (84%) and patients (85%) were unlikely to have participated or know someone who has participated in PGx testing. Pharmacists and patients expressed similar concerns about privacy of their PGx data by employers (p=0.287) and insurers (p=0.953), a potential barrier to PGx implementation. Conclusion Pharmacists are well positioned to spearhead PGx consultations and patients are interested in pharmacists using PGx to help manage their medications; however, various barriers were identified that must be overcome for PGx to become incorporated in routine practice.

Physicians' Perceptions, Beliefs, Attitudes, and Knowledge Concerning Antimicrobial Resistance in a Brazilian Teaching Hospital

2007 ◽  
Vol 28 (12) ◽  
pp. 1411-1414 ◽  
Author(s):  
Carla Morales Guerra ◽  
Carlos Alberto Pires Pereira ◽  
Armando R. Neves Neto ◽  
Denise Mary Cardo ◽  
Luci Correa
Keyword(s):  
Antimicrobial Resistance ◽  
Teaching Hospital ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Educational Programs ◽  
Antimicrobial Susceptibility Testing ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Knowledge

This cross-sectional survey assessed physicians' perceptions, knowledge and practices concerning antimicrobial resistance. Ninety-nine percent of participants reported that they perceived antimicrobial resistance as an important problem, and 86.7% agreed that antimicrobials are overprescribed, but only 2.9% rated “practicing antimicrobial control” as the most important strategy for preventing resistance. The results of this study warrant educational programs on antimicrobial resistance and the distribution of information regarding local antimicrobial susceptibility testing.

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